Provider Demographics
NPI:1013118439
Name:WILLIAM G LURZ DDS
Entity Type:Organization
Organization Name:WILLIAM G LURZ DDS
Other - Org Name:BASSETT DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF DENTAL CLINIC
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:LURZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-684-2919
Mailing Address - Street 1:102 E SOUTH ST PO BOX 98
Mailing Address - Street 2:BASSETT DENTAL CLINIC
Mailing Address - City:BASSETT
Mailing Address - State:NE
Mailing Address - Zip Code:68714-0098
Mailing Address - Country:US
Mailing Address - Phone:402-684-2919
Mailing Address - Fax:402-684-2919
Practice Address - Street 1:102 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-0098
Practice Address - Country:US
Practice Address - Phone:402-684-2919
Practice Address - Fax:402-684-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5283122300000X
52831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid